Geriatric Nurses? Attitudes Towards the Use of Nasogastric Feeding-Tubes in Demented Patients

Abstract

Geriatric nurses’ attitudes towards the use of nasogastric feeding‐tubes in severely demented patients were evaluated. A questionnaire was administered to 232 geriatric nurses asking whether they would favour enteral feeding for demented patients who were unable or refused to eat. The great majority of nurses (73.3%) were favourable; previous experience with nasogastric feeding‐tubes and a moderate to high level of religiosity were both significantly associated with this attitude. For the great majority (70.6%) of those favourable the patient's mental status was immaterial to their attitude. Also irrelevant were patients’ and/or caregivers’ wishes and economic and quality of life issues. This survey suggests that the majority of nurses consider enteral feeding as an ordinary basic practice, disregarding the complexity of the problem, which needs an individualized, multifaceted approach.

Percutaneous endoscopic gastrostomy: an effective strategy for gastrostomy feeding in patients with dementia

“…Some healthcare professionals (particularly nurses) believe feeding is a basic human requirement that should not be denied, irrespective of cognitive function. 22,23 By contrast, physicians experienced in the care of the elderly are less willing to favour any form of tube feeding in severely demented patients. 24 In Canadian studies, 30% of carers who had consented to PEG insertion subsequently expressed uncertainty about whether the right decision had been made.…”

Nurses’ attitudes towards artificial food or fluid administration in patients with dementia and in terminally ill patients: a review of the literature

“…Nurses tended to have a more positive than negative attitude towards administering artificial food and fluid therapy. The percentages of proponents varied widely from 18%,44 26%,42 and 51%,36 to about 73%,35 39 whereas the percentages of opponents ranged from 10%,42 and 27%35 39 to 62% 44…”

“…The articles of Wurzbach37 38 represent two publications derived from the same study; therefore, we considered them as one study. Five studies were classified as being qualitative,24 28 35 37 38 41 and eight were classified as being quantitative 33 34 36 39 40 42 – 44. We also identified one mixed-method study that used both qualitative and quantitative approaches 29.…”

“…We also identified one mixed-method study that used both qualitative and quantitative approaches 29. Six studies dealt with demented patient populations,28 36 39 41 42 44 six studies concentrated on terminally ill patients,24 29 33 34 37 38 40 and two studies focused on both populations 35 43…”

Feeding tube use in Italian nursing homes: The role of cultural factors

“…9 -11 In 1996, a study on 232 Italian geriatric nurses evaluated their attitude towards the use of enteral nutrition in severely demented patients, finding that a great majority of them (73.3%) favored the use of FTs regardless of the severity of patient's mental status. 10 More recently, Lubart and colleagues 11 found that NH staff and patients' relatives are often ambivalent toward FT use, on the one hand believing that it is an essential procedure for delivering food and fluids for life support, but on the other hand fearing that FT use may prolong a life of suffering. In this light, it should be hypothesized that the cultural leadership of NH physicians may have played a critical role for counterbalancing the attitudes of nurses and relatives towards the use of FT. Another factor that may be related to low FT use in our facilities is the presence of a team of trained volunteers.…”